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To hell (the Hill) and back

Back on Feb. 14, 2012, several hundred individuals representing businesses, organizations, or trade groups arrived in Washington, D.C., for the two-day AAHomecare Washington Legislative Conference. Each carried one basic message to deliver to their legislators: Repeal and replace DME bidding with the market-pricing program (MPP). We were upstaged late on the evening of Feb. 14, when the budget conferees did something unusual in Washington these days: They agreed to a bipartisan bill to extend the tax credit, extend unemployment benefits, and extend the SGR cuts until Dec. 31, 2012. This bill passed so quickly, we were not able to get MPP included.

When the news of the loss of our one and only vehicle to get MPP passed spread around the conference, you could see and hear the enthusiasm being sucked out of building. The question on everyone’s lips was, “What now?” NAIMES went to the White House executive offices on Feb. 15 and to the Hill on Feb. 16 with one message: “We must repeal and replace the current flawed bidding program and look for legislation in the near future to accomplish that goal.”

We have asked for congressional support for a plan to stop a crisis and the stark reality is that we don’t have enough support from the right people to make it happen. From the feedback I heard from suppliers and from my visits, most members of the House and Senate seem to have concerns, but the people that matter are the House and Senate leaders and committee chairs. This is a political issue and a money issue; the two are inseparable in today’s world. That, however, leaves the DME industry with a dilemma. Unless there is action to end the current DME bidding program, the words of Don Meredith from Monday Night Football come to mind: “Turn out the lights, the party’s over, all good things must come to and end.”

We are now past the rational, civil fight to save the DME industry. The gloves must come off and we, the industry and its leaders, must take this fight to Congress and the administration. We essentially have little to lose by taking a firm and passionate stand.

No doubt some might disagree, but my response is, “What’s the alternative?” This fight has been going on for 10 years and for 10 years we have followed the “pied piper of the day,” and we are far worse off today than we were 10 years ago. Suppliers were actually making a little profit and slept at night back in 2002. That was when the CBO said the bidding program would save $7.7 billion over 10 years, a number that today has been inflated to $26 billion. Medicare DME expenditures were $6.5 billion in 2002 and in the same letter, the CBO said that the DME segment would be $14 billion by 2012. They missed that number by 50% since Medicare DME costs were $7.5 billion in 2011.

The industry could fight back using the same option that the doctors use for the SGR. We could say, “No more doing business with Medicare.” We could also fight back in the November election. I’ve been told by a number of suppliers that they will not give another penny to a politician until they actually do what they say they will do. With CMS seemingly out of control, one could deduce that Congress is afraid to act. The real solution is for 15,000 DME suppliers to say to Congress and CMS, “We’re mad as hell and we aren’t taking this anymore.”